1A, B) and extention to aorta (Fig 2), but no evidance compatible with renal artries stenosis was detected. During Doppler examination, parvus-tardus pattern was demonstrated in both renal arteries (Fig. According to these findings and the assumption of RAS, DU evaluation of renal arteries was recommended. During physical examination, BP was 160/100 mmHg in his left brachial. This suspicion arises from negative family history and risk factor, and development of resistant hypertension. He was referred by a general practitioner for investigation of his secondary hypertension. So in such cases, the presence of a parvus-tardus pattern in both renal arteries on DU should suggest the diagnosis of AC or aortic valve stenosis, that AC diagnosis was made at last by further evaluation for our cases.Ī 21-year-old male with six-month history of tacking beta blocker. Parvus-tardus waveform was demonstrated in Doppler Ultrasonography (DU) study without evidence of Renal Artery Stenosis (RAS). We recently encountered four patients who were referred to excluding the renovascular hypertension. Some of such patients are referring to nephrologists to evaluate their secondary hypertension. Although suspicion of AC raises during routine physical examination by detecting Blood Pressure (BP) difference between arm and leg, AC can be presented during adulthood with isolated or resistant hypertension and without significant difference in BP between the upper and lower extremities. This disease should be diagnosed and treated early in life, because untreated AC develops systemic hypertension and subsequent morbidity and mortality due to cardiovascular diseases. Furthermore, the suspicion of AC can be raised by a bilateral renal arteries "parvus-tardus" Doppler flow pattern in young hypertensive patients screened for secondary hypertension.Īortic Coarctation (AC) is a congenital malformation of the aorta accounting for 6–8% of congenital cardiovascular disease. ConclusionĬareful physical examination should be performed in all hypertensive patients. In all, echocardiographic and angiographic work-ups showed aortic coarctation. We found in all 4 patients (age range 10 to 27 years) a bilateral "parvus-tardus" renal Doppler flow pattern. All met the following inclusion criteria: 1) arterial hypertension at age <30 years 2) referred for renal DU to rule out renovascular hypertension. We enrolled 4 consecutive patients referred to renal artery Doppler Ultrasonography (DU) for diagnostic work-up of secondary arterial hypertension. To describe a novel renal artery Doppler flow pattern pathognomonic of aortic coarctation. Diagnosis of AC is made during routine physical examination by detection of Blood Pressure (BP) difference between arm and leg. Aorta Coarctation (AC) is uncommon condition that in most adult patients is asymptomatic.
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